Coronary artery disease occurs when blood vessels that provide the heart with blood become narrow. This results from the build up of fatty deposits along the arterial walls. As the deposits build up, the arteries clog, causing flow to the heart to become impaired. This can result in a heart attack. During early stages of fatty deposit buildup, there may be no symptoms experienced, however, when deposits continue to accumulate, symptoms may include chest pain, tightness in the chest and shortness of breath after exertion. If the artery becomes blocked completely, a heart attack may occur. Because there are no symptoms during the early stages of coronary artery disease, routine physicals can help to diagnosis this condition before a heart attack occurs. Oftentimes, the patient will have hypertension and/or high cholesterol. Those with more advanced stages of this condition normally will experience symptoms, leading them to their physician.
The physician will perform a physical examination, take a medical history and order routine blood work. An electrocardiogram (EKG) will be performed, which can provide evidence of a heart attack or if one has occurred earlier. The physician may also order a holter monitor to be worn for 24 hours. This device records abnormalities with the heart's blood flow while engaging in normal activities. If coronary disease is suspected or found, the physician will usually refer the patient to a Washington cardiologist who specializes in heart disease.
The cardiologist can use several different types of diagnostic tools to identify coronary artery disease. These can include an echocardiogram (ECG), which produces images of the heart's muscle using sound waves. This test can determine the heart's ability to pump blood. If results indicate that certain parts are not pumping properly, this can help diagnose a previous or current problem. The cardiologist may also perform a stress test if symptoms occur more often during exertion. This test requires walking on a treadmill or riding a stationary bike while an ECG is being performed. Stress tests can also be done to measure the blood flow to the heart's muscle while resting and during exercise by doing a Washington nuclear cardiology stress test. This requires injecting trace amounts of radioactive material into the blood stream so a camera can identify if areas of the muscle are not receiving enough flow. Another valuable test that can help determine if angioplasty or bypass surgery is indicated is a positron-emission tomography (PET). This nuclear cardiology diagnostic test outlines the area of the heart that is not receiving proper blood supply due to a blockage.
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